Insights & Discussion
The study indicates a positive link between Irritable Bowel Syndrome (IBS) and Blastocystis infection, with no such association found for Dientamoeba fragilis infection.
For the methodology, a comprehensive search was conducted on academic databases including PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane up until February 2017, to gather studies relating to the potential association between IBS and the infections of Blastocystis and Dientamoeba fragilis. From these sources, 17 relevant studies encompassing 5882 participants (2527 patients and 3310 controls) were chosen. Pooled odds ratio and confidence intervals were computed utilizing a random effects meta-analysis model.
In the discussion, the analysis showed that individuals with Blastocystis infection are more likely to have IBS. This association was not seen with Dientamoeba fragilis infection. Additionally, in a subgroup analysis for Blastocystis infection, there were significant positive associations in all control groups. Subtypes ST1 and ST3 of the Blastocystis infection were also recognised as potential risk factors for IBS. Thus, the results affirm a positive relationship between Blastocystis infection and IBS.
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Consuming green kiwifruits is associated with a clinically relevant increase of ≥ 1.5 complete spontaneous bowel movements per week in those experiencing constipation.
2022 American Journal of Gastroenterology Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort—Results of an International Multicenter Randomized Controlled Trial Gearry R, Fukudo S, Barbara G, Kuhn-Sherlock B, Ansell J, Blatchford P, et al.
Randomised Controlled Trial Constipation Irritable Bowel Syndrome Kiwifruit
Participants included healthy controls (n = 63), patients with functional constipation (FC, n = 60), and patients with constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume 2 green kiwifruits or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week washout, and then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week. Secondary outcomes included GI comfort which was measured using the GI symptom rating scale, a validated instrument. Data (intent-to-treat) were analyzed as difference from baseline using repeated measures analysis of variance suitable for AB/BA crossover design.
Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, P < 0.0001, IBS-C; 1.73, P = 0.0003) and significantly improved measures of GI comfort (GI symptom rating scale total score) in constipated participants (FC, P < 0.0001; IBS-C, P < 0.0001). No significant adverse events were observed.
Xiao Yao San can improve symptoms and reduce recurrence rates in patients with disorders of gut-brain interaction.
2022 Frontiers in Pharmacology Efficacy and Safety of Chinese Herbal Medicine Xiao Yao San in Functional Gastrointestinal Disorders: A meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials Liu Q, Shi Z, Zhang T, Jiang T, Luo X, Su X, et al.
Systematic Review Constipation Functional gastrointestinal disorders Indigestion
The paper's methodology involved a meta-analysis of randomized controlled trials found in seven databases, up until November 22, 2021. The trials, which totaled 48 all together, were included to determine the efficacy of Xiao-Yao-San in treating disorders of gut-brain interaction (previously known as functional gastrointestinal disorders). A range of measures, including therapeutic efficacy, symptom score, Self-Rating Anxiety Scale score, Self-Rating Depression Scale score, and the recurrence rate, were analysed using both random-effects and fixed-effects models, as well as trial sequential analysis.
In terms of results, Xiao-Yao-San showed a marked improvement in the effective rate of managing disorders of gut-brain interaction compared to western drugs, both when used alone and in combination with western medicine. The paper also found the treatment notably reduced symptom scores, anxiety scores, and depression scores for patients with the disorder. Further, instances of recurrence were also reduced. Overall, Xiao-Yao-San was well tolerated and no serious adverse events were reported in any of the trials included in this analysis.
Traditional Chinese medicine therapies, like acupuncture and moxibustion, effectively alleviate irritable bowel syndrome with diarrhea symptoms, and reduce recurrence rates.
2022 Frontiers in Medicine External therapy of traditional Chinese medicine for treating irritable bowel syndrome with diarrhea: A systematic review and meta-analysis Wei X, Wen Y, Wei Y, Liang X, Ma X, Zhang B, et al.
Systematic Review Chinese Medicine Diarrhoea Irritable Bowel Syndrome
Adhering to the guidelines for systematic reviews, multiple databases including PubMed and Cochrane Library, and several Chinese databases were thoroughly searched. The focus was randomized controlled trials that compared traditional Chinese external therapies with western medicine for irritable bowel syndrome with diarrhea up until the end of 2021. Two authors were independently responsible for screening, data extraction and study assessment. Study quality assessment involved both the Jadad scale and Cochrane Collaborative's risk of bias tool. Meta-analysis was performed on the data collated using Review Manager software.
The gathered data revealed that of the twenty-one studies examined, including a total of 1,862 subjects, acupuncture and moxibustion were the most prevalent external therapies. The results of the meta-analysis indicated that in comparison to the control group, the experimental group demonstrated marked improvement. Notably, the experimental group had superior clinical effectiveness rates, better clinical cure rates, and reduced recurrence. Additionally, there was significant improvement in irritable bowel syndrome related quality of life within the experimental group. Despite these promising results, the publication bias of the included studies was noted as a potential limitation.
Acupuncture combined with moxibustion showed the best outcomes in terms of efficacy and quality of life improvement for adults with irritable bowel syndrome complicated with diarrhea.
2022 Computational and Mathematical Methods in Medicine Acupuncture and Moxibustion in the Treatment of Adult Diarrhea Irritable Bowel Syndrome: A Network Meta-analysis Jiang X, Guo X, Zhou J, Ye S
Meta-Analysis Acupuncture Diarrhoea Irritable Bowel Syndrome
The study was conducted by searching major databases, including PubMed, The Cochrane Library, Embase, and database from China, for randomized controlled trials. These trials explored the effects of acupuncture and moxibustion on individuals suffering from irritable bowel syndrome complicated with diarrhea. The selected studies underwent a rigorous bias assessment and their data were analyzed using Stata 16.0 statistical software.
The analysis encompassed 21 studies overall, considering 1626 patients undergoing 8 different therapeutic measures. The study found that treatments such as acupuncture, warming needle moxibustion, and a combination of acupuncture with sandwiched or heat-sensitive moxibustion revealed significantly improved outcomes when compared to the drug pinaverium bromide. On the other hand, pinaverium bromide demonstrated the lowest efficacy and effect on quality of life. The most frequently used acupuncture points were GV20, GV29, ST 25, ST37, ST36, SP6, LR3, and CV12.
Peppermint oil proved more effective than placebo in treating irritable bowel syndrome symptoms, but with an increased rate of adverse events.
2022 Alimentary Pharmacology & Therapeutics Systematic review and meta‐analysis: efficacy of peppermint oil in irritable bowel syndrome Ingrosso MR, Ianiro G, Nee J, Lembo AJ, Moayyedi P, Black CJ, et al.
Systematic Review Irritable Bowel Syndrome Peppermint Oil
In evaluating the effectiveness and safety of peppermint oil for irritable bowel syndrome, the researchers searched medical literature for randomised controlled trials involving peppermint oil treatments in IBS. A systematic review and analysis included trials up to the date of April 2nd, 2022. The team assessed the efficacy and safety of the peppermint oil treatment based on various factors including effect on global IBS symptoms and abdominal pain along with incidence of adverse events or gastro-oesophageal reflux.
From the literature review, 10 suitable randomised control trials were identified, encompassing a total of 1030 patients. The results showed that peppermint oil performed better than a placebo in lessening overall irritable bowel syndrome symptoms and reducing abdominal pain. However, this was coupled with a higher rate of recorded adverse events in patients who were administered peppermint oil. Despite the positive performance of peppermint oil over placebo, the evidence quality considered for this conclusion was very low.
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